gi a warning to t whole delive system because as soon as you warn them, they'll sta to selfrganize, toe they need to be. and you begin the process and even to make it easier y can salet's fos on the top thr or five condions that are t most expensive in medice. and when you do that, you're going to be covering aut 60% to 70% of all th spending that we have many medicare. so the proposal. i like the proposal. thdetails will make dierence. >> rose:here acommon denominator why ere is a regional differee in terms of effeive health care? >> i'l try to put in the one word. i think it hasto do with culture. culture of the physician. ultimately if i ve to put in the one wordt's the ideaf e culture. you can look at certain regions of the countrynd find totly different styles of practices in the same state with people who are separated by00 or 300 miles. there ju seems to be a difference. wh you look in colorado and grand junction, there's no rea integrated gup practices. butheoctors there-- i don't know how it's happened-- work in a y that that concentra on the physicians, they hav a way to dist